Introduction: Oxidative stress (OS) is strongly envolved in the pathogenesis of many preterm newborn diseases; this is due to the low efficiency of natural antioxidant systems unable to counteract the harmful effects of free radicals (FRs). Necrotizing Enterocolitis (NEC) is a multifactorial disease and it is part of the so called free radicals related diseases. Hypoxic-ischaemic events and inflammation, involved in NEC pathogenesis, are responsible of the overproduction of free radicals (FRs), generating OS. Aim: To test the hypotesis that OS marker levels in cord blood may predict the onset of NEC in high risk infants. Materials and methods: 91 preterm newborns of gestational age between 24 and 33 weeks and birth weight between 460 and 2540 grams were consecutively recruited in two italian neonatal intensive care units. Markers of potential oxidative stress risk, Non Protein Bound Iron (NPBI), and free radicals damage, Advanced Oxidation Protein Products (AOPP) and Total Hydroperoxide (TH), were measured in the cord blood. Associations between NEC and OS markers have been checked through inferential analysis (univariate logistic regression). Results: Out of 91 preterm babies, 8 developed NEC. Babies with NEC had a birth weight (BW) and a gestational age (GA) significantly lower than healthy babies (BW=1100,52 ± 444,30 vs 1320,53 ± 462,09; GA=29,02 ± 2,09 vs 30,14 ± 2,33, respec- tively. p<0.005). Cord blood levels of TH and NPBI were higher in babies with NEC than in babies without, but not significantly. AOPP cord blood levels were significantly higher in babies with NEC than the babies without (AOPP=29,15 ± 20,02 vs 16,72 ± 7,34; p<0.05). AOPP demonstrated a significant value for the identification of the risk of NEC (OR=1.13, CI 95%= 1.001-1.282). Conclusions: OS is strongly associated with NEC. The determination of biochemical OS markers in cord blood can be useful in identifying babies at high risk to develop NEC and in devising new strategies to bring consistent benefits to premature babies.
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机译：简介：氧化应激（OS）强烈参与了许多早产新生儿疾病的发病机制。这是由于天然抗氧化剂系统效率低下，无法抵消自由基（FRs）的有害影响。坏死性小肠结肠炎（NEC）是一种多因素疾病，是所谓的自由基相关疾病的一部分。缺氧缺血性事件和炎症与NEC发病机制有关，是自由基（FRs）过量产生，产生OS的原因。目的：为了检验以下假设：脐带血中的OS标记物水平可以预测高危婴儿的NEC发作。材料和方法：在两个意大利新生儿重症监护病房中连续招募了91名胎龄在24至33周之间，出生体重在460至2540克之间的早产儿。在脐带血中测量潜在的氧化应激风险，非蛋白结合铁（NPBI）和自由基损伤，高级氧化蛋白产物（AOPP）和总氢过氧化物（TH）的标记。 NEC和OS标记之间的关联已通过推论分析（单因素逻辑回归）进行了检查。结果：在91名早产儿中，有8名发展为NEC。 NEC婴儿的出生体重（BW）和胎龄（GA）显着低于健康婴儿（BW = 1100,52±444,30与1320,53±462,09; GA = 29,02±2,09分别为30,14±2,33。p<0.005）。 NEC婴儿的脐血TH和NPBI水平高于无NEC的婴儿，但无统计学意义。患有NEC的婴儿的AOPP脐带血水平显着高于未患新生儿的AOPP（AOPP = 29,15±20,02 vs，16,72±7,34; p <0.05）。 AOPP证明对NEC风险的识别具有重要价值（OR = 1.13，CI 95％= 1.001-1.282）。结论：OS与NEC密切相关。脐带血中生化OS标记的测定可用于识别高风险新生儿NEC婴儿，并设计新策略为早产婴儿带来一致的益处。
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